Larceny simply means theft or
stealing. In this case, the property allegedly stolen is a public record.

For you to find the defendant guilty
of this charge, the state must prove the following elements beyond a reasonable
doubt:

Element 1 - Theft of propertyThe first element is that the
defendant wrongfully (took / obtained / withheld) property from the owner.

<See
Larceny, Instruction 9.1-1, for a full explanation of this element.>

Element 2 - Larcenous intentThe second element is that at the time
the defendant (took / obtained / withheld) the property, (he/she) intended to <insert
as appropriate:>

permanently deprive
the owner of the public record.

permanently
appropriate the public record to (himself/herself) or a third person.

<See
Larceny, Instruction 9.1-1, for a full explanation of this element.>

Element 3 - Public recordThe third element is that the property
is a public record, writing or instrument kept, held or deposited according to
law with or in the keeping of any public office or public servant. <Describe
the nature of the record.>

Conclusion

In summary, the state must prove
beyond a reasonable doubt that the defendant 1) wrongfully (took / obtained /
withheld) property from the owner, 2) (he/she) did so with the intent to
(permanently deprive the owner of (his/her) property / permanently appropriate
the property to (himself / herself) or a third person), and 3) the property was
a public record.

If you unanimously find that the state has proved beyond a
reasonable doubt each of the elements of the crime of larceny in the third
degree, then you shall find the defendant guilty. On the other hand, if you
unanimously find that the state has failed to prove beyond a reasonable doubt
any of the elements, you shall then find the defendant not guilty.